Document Detail


Measurement of ischemia by changes in tissue oxygen, carbon dioxide, and pH.
MedLine Citation:
PMID:  10369235     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We evaluated the ability of brain tissue oxygen pressure (PO2), carbon dioxide pressure (PCO2), and pH to detect regional ischemia produced by temporary brain artery occlusion, compared with a group without artery occlusion. METHODS: Patients undergoing craniotomy for cerebrovascular surgery were recruited for this study. A 0.5-mm-diameter probe was inserted into brain tissue to measure PO2, PCO2, and pH continuously. Group 1 (n = 15) did not receive brain artery occlusion during their surgical procedure. In Group 2, brain artery occlusion was produced for aneurysm clipping (n = 10) or extracerebral to intracerebral artery bypass (n = 3). Mean arterial pressure was maintained above 90 mmHg in both groups. Measurements were made after artery occlusion or sham treatment and compared with baseline. RESULTS: Under baseline conditions, tissue PO2, PCO2, and pH were not different between the groups. In Group 2, brain artery occlusion for a median time of 7 minutes (range, 2-48 min) significantly decreased PO2 and pH and increased PCO2 compared with baseline. There were no significant changes in Group 1. During artery occlusion, PO2 decreased below 10 mmHg and/or pH decreased below 7.0 in 8 of 13 patients. CONCLUSIONS: Regional brain ischemia can be consistently detected and treated by monitoring tissue metabolism. It will be necessary in the future to identify critical levels and duration of decreases in PO2 and pH that lead to irreversible neuronal injury.
Authors:
W E Hoffman; F T Charbel; G Gonzalez-Portillo; J I Ausman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  51     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-06-23     Completed Date:  1999-06-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  654-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of Illinois at Chicago, USA.
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MeSH Terms
Descriptor/Qualifier:
Brain / metabolism*
Brain Ischemia / metabolism*
Carbon Dioxide / metabolism*
Humans
Hydrogen-Ion Concentration
Intracranial Aneurysm / metabolism*,  surgery
Oxygen / metabolism*
Prospective Studies
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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